Provider Demographics
NPI:1780862839
Name:SPEER, WENDI MICHELLE (PT)
Entity Type:Individual
Prefix:MS
First Name:WENDI
Middle Name:MICHELLE
Last Name:SPEER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 STONE ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5347
Mailing Address - Country:US
Mailing Address - Phone:870-275-6438
Mailing Address - Fax:870-275-6439
Practice Address - Street 1:1707 STONE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5347
Practice Address - Country:US
Practice Address - Phone:870-275-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT30452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics